The Fate of Residual Fragments After Retrograde Intrarenal Surgery in Long-Term Follow-up

Urol J. 2019 Feb 21;16(1):1-5. doi: 10.22037/uj.v0i0.4124.

Abstract

Purpose: We aimed to describe the natural history of stone fragments ? 7 mm that remained after retrograde intrarenalsurgery (RIRS) in long-term follow-up.

Materials and methods: We retrospectively reviewed 142 medical records of patients who had residual fragments (RFs) ? 7 mm after RIRS. Patients were divided into 2 groups according to the size of RFs as ? 4 mm (group 1) and 5 - 7 mm (group 2). Patients' demographic data, stone characteristics, perioperative data and complications were recorded. Re-growth of RFs, spontaneous passage, renal colic, infection and re-operation rates were our main variables.

Result: A total of 142 patients (86 in group 1 / 56 in group 2) were followed for mean 54.45 ± 14.24 and 56.22 ± 10.28 months. Mean size of RFs was 2.85 ± 1.22 mm in group 1 and 6.81 ? 2.21 mm in group 2. Mean number of RFs were 1.1 ± 0.2 in group 1 and 2.4 ± 1.6 in group 2 (P = .035). Spontaneous passage rate of RFs were 30.23% and 17.85% in group 1 and 2, respectively (P = .032). No difference was observed in the re-growth rate of RFs between the two groups (P = .094). Although no difference was observed in re-growth of RFs between the groups, patients in group 2 were more likely to experience stone-related events such as renal colic and re-intervention rate (P = .034, P = .029; respectively).

Conclusion: Our results demonstrate that RFs > 4 mm take higher risk in terms of stone-related events and shouldbe followed up more closely.

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Calculi / complications
  • Kidney Calculi / pathology*
  • Kidney Calculi / surgery*
  • Lithotripsy, Laser
  • Male
  • Middle Aged
  • Particle Size
  • Recurrence
  • Renal Colic / etiology
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome